Research published in Anaesthesia (a journal of the Association of Anaesthetists) reveals the impact of COVID on organ donation in the UK, with both eligible organ donors and actual organ donations falling by 30% during the first year of the pandemic.
The comprehensive study analysing UK data is by Dr Dan Harvey, Consultant in Intensive Care Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK, and Clinical Lead for Innovation and Research Organ Donation at NHS Blood and Transplant (NHSBT), and Dr Nicholas Plummer, Specialist Registrar in Anaesthesia and Intensive Care Medicine at Nottingham University Hospitals NHS Trust, Nottingham, UK, and colleagues.
The national audit data from NHSBT – the agency that oversees donation in the UK - show that, in the first year of the COVID-19 pandemic (March 11, 2020 to March 10, 2021) the total number of donations fell by 30% from 1620 to 1140 when compared with pre-pandemic levels.
Adjusted numbers of donors and organs retrieved were inversely dependent on Intensive Care Unit burden of COVID-19 patients, though weekly numbers of transplants were unrelated. There were overall around 30% fewer eligible donors (4282) in the first year of the pandemic when compared with the previous year (6038). This was partly because there were fewer in-hospital deaths from conditions more frequently associated with donation, such as cardiac arrest (down 17%) and intracranial catastrophes (down 12%) throughout the first year of the pandemic.
The pandemic also led, both directly and indirectly, to increased numbers of people who died in the community who might otherwise have died in hospital and been eligible donors. However, even though absolute numbers were down, the proportion of eligible donors who proceeded to donation (27%) was unchanged in the year of the study compared to the year before the pandemic.
The authors say that, despite all these challenges, "the relative proportion of eligible donors proceeding to donation and the relationship between retrieved organs and transplantations remained constant, suggesting a resilient organ donation and transplantation system despite unprecedented pressures placed on ICU and the wider healthcare system."
The authors conclude: "Although the COVID-19 pandemic impacted on organ donation and transplantation in the UK, as it has in many other countries, the system showed a degree of resilience and ability to rapidly adapt to challenges to maintain services…It is a credit to the UK population, as well as to NHSBT, that public support for organ donation was maintained. As organ donation organisations seek to recover from the pandemic in 2022 and beyond, further work is needed to continually assess the impact of COVID-19 on transplant programmes worldwide to consider where further adaption can help to reduce its impact on transplantation rates and prepare for future challenges to the system."
